| A. A marked incongruence between one’s experienced/expressed gender and natal gender of at least 6 mo in duration, as manifested by at least two of the following: |
| 1. A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics (or in young adolescents, the anticipated secondary sex characteristics) |
| 2. A strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender (or in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics) |
| 3. A strong desire for the primary and/or secondary sex characteristics of the other gender |
| 4. A strong desire to be of the other gender (or some alternative gender different from one’s designated gender) |
| 5. A strong desire to be treated as the other gender (or some alternative gender different from one’s designated gender) |
| 6. A strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s designated gender) |
| B. The condition is associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning. |
| Specify if: |
| 1. The condition exists with a disorder of sex development. |
| 2. The condition is posttransitional, in that the individual has transitioned to full-time living in the desired gender (with or without legalization of gender change) and has undergone (or is preparing to have) at least one sex-related medical procedure or treatment regimen—namely, regular sex hormone treatment or gender reassignment surgery confirming the desired gender (e.g., penectomy, vaginoplasty in natal males; mastectomy or phalloplasty in natal females). |
| A. A marked incongruence between one’s experienced/expressed gender and natal gender of at least 6 mo in duration, as manifested by at least two of the following: |
| 1. A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics (or in young adolescents, the anticipated secondary sex characteristics) |
| 2. A strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender (or in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics) |
| 3. A strong desire for the primary and/or secondary sex characteristics of the other gender |
| 4. A strong desire to be of the other gender (or some alternative gender different from one’s designated gender) |
| 5. A strong desire to be treated as the other gender (or some alternative gender different from one’s designated gender) |
| 6. A strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s designated gender) |
| B. The condition is associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning. |
| Specify if: |
| 1. The condition exists with a disorder of sex development. |
| 2. The condition is posttransitional, in that the individual has transitioned to full-time living in the desired gender (with or without legalization of gender change) and has undergone (or is preparing to have) at least one sex-related medical procedure or treatment regimen—namely, regular sex hormone treatment or gender reassignment surgery confirming the desired gender (e.g., penectomy, vaginoplasty in natal males; mastectomy or phalloplasty in natal females). |
Reference: American Psychiatric Association (14).
| A. A marked incongruence between one’s experienced/expressed gender and natal gender of at least 6 mo in duration, as manifested by at least two of the following: |
| 1. A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics (or in young adolescents, the anticipated secondary sex characteristics) |
| 2. A strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender (or in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics) |
| 3. A strong desire for the primary and/or secondary sex characteristics of the other gender |
| 4. A strong desire to be of the other gender (or some alternative gender different from one’s designated gender) |
| 5. A strong desire to be treated as the other gender (or some alternative gender different from one’s designated gender) |
| 6. A strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s designated gender) |
| B. The condition is associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning. |
| Specify if: |
| 1. The condition exists with a disorder of sex development. |
| 2. The condition is posttransitional, in that the individual has transitioned to full-time living in the desired gender (with or without legalization of gender change) and has undergone (or is preparing to have) at least one sex-related medical procedure or treatment regimen—namely, regular sex hormone treatment or gender reassignment surgery confirming the desired gender (e.g., penectomy, vaginoplasty in natal males; mastectomy or phalloplasty in natal females). |
| A. A marked incongruence between one’s experienced/expressed gender and natal gender of at least 6 mo in duration, as manifested by at least two of the following: |
| 1. A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics (or in young adolescents, the anticipated secondary sex characteristics) |
| 2. A strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender (or in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics) |
| 3. A strong desire for the primary and/or secondary sex characteristics of the other gender |
| 4. A strong desire to be of the other gender (or some alternative gender different from one’s designated gender) |
| 5. A strong desire to be treated as the other gender (or some alternative gender different from one’s designated gender) |
| 6. A strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s designated gender) |
| B. The condition is associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning. |
| Specify if: |
| 1. The condition exists with a disorder of sex development. |
| 2. The condition is posttransitional, in that the individual has transitioned to full-time living in the desired gender (with or without legalization of gender change) and has undergone (or is preparing to have) at least one sex-related medical procedure or treatment regimen—namely, regular sex hormone treatment or gender reassignment surgery confirming the desired gender (e.g., penectomy, vaginoplasty in natal males; mastectomy or phalloplasty in natal females). |
Reference: American Psychiatric Association (14).
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